Toothboost: a new solution in oral care

09 December, 2019 / indepth
 Will Peakin  

A Scottish start-up has developed a technology to remineralise teeth ‘on the go’

Novel and successful biotech products often spring from the laboratory; the result of groundbreaking research that is ‘spun out’ from a university and brought to market by a new company or through a licensing deal with an established firm.

“In developing Toothboost, I started with the consumer – my patients – in mind, and an unmet need in oral care products,” said Carol Rafferty. “Since then we’ve been on a journey in reverse. It’s coming up for five years now; from product concept to formulation, and then back out again through scientific testing, regulation, IP (intellectual property), consumer and dental professional market research, and now our route to market.”

We want to enable consumers to do more to protect and strengthen their teeth on-the-go

Carol Rafferty

Carol, a dental hygienist with more than 30 years’ experience, is the co-founder of Dentherapy, the latest addition to Scotland’s dental research and development (R&D) eco-system, led by established companies such as Calcivis, and BioFilm, who are already marketing approved innovative dental technologies and devices, and Reminova, an established R&D company with products on the pre-clinical approval track.

Dentherapy is initially focused on the consumer market and its formulation can be delivered in a range of oral care products. Last month, the Aberdeen-based company’s patent applications in the US and EU were published and it is now exploring partnerships with multinational consumer and oral health companies who have expressed interest in the technology and ‘on the go’ product concept.

Carol began her career in general dental practice and worked in the salaried dental service. In 2006, she led the establishment of NHS Education Scotland training schemes for dental nurses in Grampian and Tayside. In parallel, she completed a master’s degree in health promotion at Robert Gordon University. “It was then I started thinking about what I could do next with my skills,” she said.

“As a dental hygienist I was increasingly aware of the effect dietary choices and busy lifestyles were having on oral health. Snacking and grazing habits increase consumption of sugar and acidic foods and drinks, promoting an acidic environment. This results in frequent periods of demineralisation of the tooth structure, causing enamel erosion or carious lesions, leading to permanent tooth structure loss.

“Part of my role was to give dietary advice and recommend ‘daily use’ oral care products to support patients’ dental health needs and concerns. This raised the question, what products can I advise patients to use directly after consuming sugar or acidic foods and drinks in order to boost remineralisation? Why were there no ‘therapeutic’ products that consumers could easily use on the go, to protect their teeth directly after eating and drinking?”

Carol added: “Toothpaste and mouthwash remineralising products tend to be restricted to daily home use, due to the inconvenience of finding a sink and the potential embarrassment of brushing your teeth in public. Consumer discovery confirmed people are keen to do more to protect and care for their teeth and are investing in cosmetic products and treatments to improve their smile.

“The time seemed right for a product range that supplemented at-home oral care routines. The idea is to develop efficacious products that are convenient to use at any time and anywhere, with great taste. The challenge was where to start!”

At that moment of realisation in 2014, Carol sat down with a friend Katherine Thom – today, her fellow director at Dentherapy – and the two began discussing the idea of developing a new oral health product and establishing Dentherapy Ltd. Their first point of contact was Dr Howard Marriage, Entrepreneur in Residence at the University of Edinburgh, and a family friend, whose wife she had met when they were studying for their MSc degree.

Dentherapy co-founders Carol Rafferty (right) and Katherine Thom.

Howard provided initial guidance and encouraged them to seek support from Scottish Enterprise, which subsequently provided a grant to research the market and any existing intellectual property. Through Interface, the organisation connecting Scottish business with academia, Carol and Katherine put out a call to universities that might be interested in developing a novel remineralisation product.

The aim, she said, is to deliver a dose of calcium, phosphate, and fluoride at precisely the moment when the tooth surface is at its most vulnerable, post-acidic incident, to promote remineralisation. “We wanted to create a formulation that worked with the mouth’s protective environment, boosting saliva’s buffering action to neutralise acids and deliver bioavailable calcium, phosphate, and fluoride,” said Carol.

Initial research highlighted a number of possible formulation ingredients including a multifunctional bioactive protein made by a multinational company and so Carol established contact. The manufacturer of the innovative ingredient continues to collaborate with Dentherapy on the project. The next step was to find experts to help with first-phase formulation development and in-vitro testing.

Carol alighted on a scientific paper co-authored by Dr Richard Willson, Director of Modus Laboratories. Richard was previously senior formulation specialist at GSK and part of the team that developed Sensodyne Pronamel toothpaste. He led Dentherapy’s collaborative remineralisation study conducted with Calcivis, Monitoring Erosive Lesion Treatment by Toothboost Technology, the results of which were presented to the International Association of Dental Research (IADR) in 2018. “Toothboost provides an effective alternative remineralising treatment for eroded enamel lesions,” it concluded.

Dr Chris Longbottom, one of the team who developed the Calcivis imaging system, commented: “Toothboost technology bridges the gap between at home and professional remineralising agents, addressing an unmet need and opportunity in the global oral care market.”

According to the published patent application, the formulation’s inventors – Dr Willson and Edinburgh-based technical consultant Dr David Smillie – have created a liquid composition, comprising stabilised calcium, phosphate, and fluoride.

“On application the composition provides the active components… in a way that is efficacious in the repair of enamel and for the protection damage to enamel when subjected to an acid challenge.”

The patent is another milestone for Carol and her colleagues, and it is anticipated that additional patent applications will support further formulation development claims.

The formulation has exceeded the team’s expectations, and includes inhibition of oral biofilm formation, stability and adherence; delivering bioavailable calcium phosphate and fluoride; remineralising erosive and carious lesions; and supporting a healthy oral microbiome.

“Our initial on the go product, Toothboost Oral Mist, delivers frequent remineralisation allowing users to counteract acidic incidents throughout the day, immediately after eating and drinking. Our follow on product is Boostpaste, an SLS and surfactant-free toothpaste,” said Carol.

She added: “We’re a small, privately-owned company currently focused on product R&D. We have received invaluable support from organisations such as Scottish Enterprise, Interface and, more recently, Opportunity North East’s (ONE) Life Science Sector and BioCity.” Dentherapy has also worked with Givaudan, the Swiss flavour specialist, to develop natural and long-lasting flavours.

“We hope to collaborate with an oral care company who share our vision for our innovative technology and product range development. We haven’t discounted taking products to market ourselves and have global ambitions.

“We are looking for optimal routes to get the technology out there – to consumers, potentially to dental professionals for clinical use, and I believe there is scope for its application in public dental health settings.”

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Tags: Innovation / Oral Care / Spray / Toothboost

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